Programming device for programming an implantable medical device for stimulating a human or animal heart

ABSTRACT

A programming device for programming an implantable medical device for stimulating a human or animal heart, wherein the programming device carries out the steps: a) allowing to select one of at least two electrode lead configurations for stimulating a heart, wherein the at least two electrode lead configurations comprise: i) a first electrode lead in which an atrial electrode lead and a right ventricular electrode lead are connected to electrode lead ports, and ii) a second electrode lead in which an atrial electrode lead and a His bundle electrode lead are connected to electrode lead ports; b) allowing to select a first timing parameter value if the first electrode lead is selected and to select a second timing parameter value if the second electrode lead is selected, wherein the first timing parameter value is an atrioventricular interval and the second timing parameter value is an atrial-His interval.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is the United States National Phase under 35 U.S.C. §371 of PCT International Patent Application No. PCT/EP2020/079748, filedon Oct. 22, 2020, which claims the benefit of European PatentApplication No. 19205046.6, filed on Oct. 24, 2019, the disclosures ofwhich are hereby incorporated by reference herein in their entireties.

TECHNICAL FIELD

The present invention relates to a programming device according to thepreamble of claim 1, to a computer program product according to thepreamble of claim 9, to an arrangement comprising such a programmingdevice and an implantable medical device according to the preamble ofclaim 10, and to a method for programming an implantable medical devicewith such a programming device according to the preamble of claim 15.

BACKGROUND

Implantable medical devices for stimulating a human or animal heart,such as pacemakers, have been known for a long time. They can performdifferent functions. Different stimulation programs can be carried outby an appropriate pacemaker to restore the treated heart to a normalstate. Pacemakers are also known to stimulate the His bundle.

The His bundle is a bundle of specific heart muscle cells that is partof the cardiac conduction system. The His bundle is located distally ofthe atrioventricular node towards the apex of the heart. The His bundleforms part of the ventricular conduction system.

There exist specific devices adapted for His bundle pacing, wherein adetecting (sensing) and stimulation electrode is not implanted into theventricle of the human or animal heart to be treated, but rather at ornear to the His bundle of the heart. Such use of a His bundle electrodeenables a particularly physiologic stimulation of the human or animalheart.

In many cases, conventional pacemakers are used for His bundle pacing.In such a case, the port to which the His bundle electrode is connectedis provided with specific stimulation/sensing parameters in order toachieve an appropriate sensing of electric signals at the His bundle andto allow a sufficient but still physiologic stimulation of the Hisbundle in case His bundle pacing is applied. These specificstimulation/sensing parameters differ from stimulation/sensingparameters used for conventional cardiac pacing.

The available programming devices for such implantable medical devicesdo not yet address the need of setting specific stimulation parametersin case of His bundle pacing. Rather, the desired stimulation parametersneed to be manually chosen without assistance by the used programmingdevices. In some cases, the available parameter value range isinsufficient for properly programming an implantable medical device forHis bundle pacing. In some cases, preset standard values areinappropriate for His bundle pacing and need to be manually adjusted bya user in each case. Some parameters necessary for His bundle pacing donot exist in case of conventional cardiac pacing so that similarconventional parameters are often used. This bears the risk that the setparameters are incorrectly interpreted during follow-up care so thatincorrect conclusions on the patient's health condition are drawn.

The present disclosure is directed toward overcoming one or more of theabove-mentioned problems, though not necessarily limited to embodimentsthat do.

SUMMARY

It is an object of the present invention to facilitate programming of animplantable medical device for stimulating a human or animal heart thatcan adopt a conventional electrode lead configuration and an atypicalelectrode lead configuration, namely an electrode lead configurationappropriate for His bundle pacing.

At least this object is achieved with a programming device having thefeatures of claim 1. Such a programming device serves for programming animplantable medical device for stimulating a human or animal heart. Theprogramming device comprises a first processor and a first memory unit.The first memory unit comprises a first computer-readable program thatcauses the first processor to perform the steps explained in thefollowing when executed on the first processor.

First, a selection between at least two electrode lead configurations ofan implantable medical device for stimulating a human or animal heart ismade possible. The at least two electrode lead configurations comprise afirst electrode lead configuration and a second electrode leadconfiguration. In the first electrode lead configuration, an atrialelectrode lead and a right ventricular electrode lead are connected tocorresponding electrode lead ports of the implantable medical device. Inthe second electrode lead configuration, an atrial electrode lead and aHis bundle electrode lead are connected to corresponding electrode leadports of the implantable medical device.

The atrial electrode lead is intended to be implanted, or is alreadyimplanted, in an atrium (in particular the right atrium) of the heart tobe stimulated so as to be able to sense electric signals at the atriumor to stimulate the atrium by delivering electric pulses.

The right ventricular electrode is intended to be implanted or isalready implanted in the right ventricle of the human heart to bestimulated. Typically, the right ventricular electrode is implanted inan apical region of the right ventricle so as to be able to stimulatethe right ventricular cardiac tissue with an electric pulse in order toachieve a stimulation of the heart to be stimulated.

The His bundle electrode is intended to be implanted or is alreadyimplanted at or near to the His bundle of the heart to be stimulated soas to be able to sense electric signals at the His bundle of the heartto be stimulated or to deliver electric pulses for a stimulation of theHis bundle in order to achieve a subsequent contraction of the heart tobe stimulated.

If the first electrode lead configuration was selected, the programmingdevice allows to select a first timing parameter value from a first setof timing parameter values. If, however, the second electrode leadconfiguration was previously selected, the programming device allows toselect a second timing parameter value from a second set of timingparameter values. In this context, the first timing parameter value is avalue of an atrioventricular interval. The second timing parameter valueis a value of an atrial-His interval.

The atrioventricular interval is the time period required between anatrial event like in an atrial pacing event or an atrial sensing eventand a subsequent ventricular stimulus (also denoted as atrioventriculartransition time). The atrioventricular interval depends on thephysiologic conditions within the heart to be stimulated.

The atrial-His interval is the time period required between an atrialevent like an atrial pacing event or an atrial sensing event and asubsequent His bundle stimulus (also denoted as atrial-His transitiontime). For one and the same cardiac cycle, the atrioventricular intervalis typically longer than the atrial-His interval.

Conventional implantable medical devices for stimulating the human oranimal heart only enable setting an atrioventricular interval value. Thepresently claimed programming device enables also to adjust the value ofan atrial-His interval.

Since the second set of timing parameter values is different from thefirst set of timing parameter values, it is possible to includephysiologically relevant timing parameter values into the second set oftiming parameter values for setting the atrial-His interval that are notconsidered in conventional implantable medical devices for stimulatingthe human or animal heart when setting the atrioventricular interval.Furthermore, it is possible to exclude physiologically irrelevant timingparameter values from the second set of timing parameter values. As aresult, no compromises are any longer necessary when setting oradjusting the atrial-His interval, whereas such setting or adjustment iscompromised in case of conventional programming devices. Due to thenovel functionality, an adequate and safe His bundle electrodeconfiguration is made possible so that the risk of an incorrectprogramming of an implantable medical device for stimulating the humanor animal heart is significantly reduced. Furthermore, it is possible toclearly indicate the second timing parameter as “atrial-His interval”(and only the first timing parameter as “atrioventricular interval”) sothat a wrong interpretation of the settings in follow-up care is alsosignificantly reduced. This facilitates the programming and use of animplantable medical device adapted for His bundle pacing.

In an embodiment, the first set of timing parameter values comprisesvalues lying in a time range of from 40 ms to 350 ms, in particular from45 ms to 345 ms, in particular from 50 ms to 340 ms, in particular from55 ms to 335 ms, in particular from 60 ms to 330 ms, in particular from65 ms to 325 ms, in particular from 70 ms to 320 ms, in particular from75 ms to 315 ms, in particular from 80 ms to 310 ms, in particular from85 ms to 305 ms, in particular from 90 ms to 300 ms, in particular from95 ms to 295 ms, in particular from 100 ms to 290 ms, in particular from105 ms to 285 ms, in particular from 110 ms to 280 ms, in particularfrom 115 ms to 275 ms, in particular from 120 ms to 270 ms, inparticular from 125 ms to 265 ms, in particular from 130 ms to 260 ms,in particular from 135 ms to 255 ms, in particular from 140 ms to 250ms, in particular from 145 ms to 245 ms, in particular from 150 ms to240 ms, in particular from 155 ms to 235 ms, in particular from 160 msto 230 ms, in particular from 165 ms to 225 ms, in particular from 170ms to 220 ms, in particular from 175 ms to 215 ms, in particular from180 ms to 210 ms, in particular from 185 ms to 205 ms, in particularfrom 190 ms to 200 ms, in particular from 190 ms to 195 ms.

In an embodiment, the first set of timing parameters comprises aplurality (more than two) of timing parameter values chosen from theprecedingly mentioned intervals or values so that an individual valuecan be selected as first timing parameter value.

In an embodiment, the first timing parameter value is preset to a timelying in a range of from 150 ms to 210 ms, in particular from 155 ms to205 ms, in particular from 160 ms to 200 ms, in particular from 165 msto 195 ms, in particular from 170 ms to 190 ms, in particular from 175ms to 185 ms, in particular from 175 ms to 180 ms.

Such a value of the first timing parameter value is appropriate forcovering most of conventional pacing scenarios so that presetting thefirst timing parameter to a value falling in this range facilitates useof the programming device. If a user wants to accept the preset value,no other value needs to be chosen. However, it is still possible toamend the first timing parameter value to a value different from thepreset value so that presetting the first timing parameter value doesnot limit the configuration possibilities.

In an embodiment, the second set of timing parameter values comprisesvalues lying in a time range of from 15 ms to 300 ms, in particular from20 ms to 295 ms, in particular from 25 ms to 290 ms, in particular from30 ms to 285 ms, in particular from 35 ms to 280 ms, in particular from40 ms to 275 ms, in particular from 45 ms to 270 ms, in particular from50 ms to 265 ms, in particular from 55 ms to 260 ms, in particular from60 ms to 255 ms, in particular from 65 ms to 250 ms, in particular from70 ms to 245 ms, in particular from 75 ms to 240 ms, in particular from80 ms to 235 ms, in particular from 85 ms to 230 ms, in particular from90 ms to 225 ms, in particular from 95 ms to 220 ms, in particular from100 ms to 215 ms, in particular from 105 ms to 210 ms, in particularfrom 110 ms to 205 ms, in particular from 115 ms to 200 ms, inparticular from 120 ms to 195 ms, in particular from 125 ms to 190 ms,in particular from 130 ms to 185 ms, in particular from 135 ms to 180ms, in particular from 140 ms to 175 ms, in particular from 145 ms to170 ms, in particular from 150 ms to 165 ms, in particular from 155 msto 160 ms.

In an embodiment, the second set of timing parameters comprises aplurality (more than two) of timing parameter values chosen from theprecedingly mentioned intervals or values so that an individual valuecan be selected as second timing parameter value.

In an embodiment, the second timing parameter value is preset to a timelying in a range of from 80 ms to 140 ms, in particular from 85 ms to135 ms, in particular from 90 ms to 130 ms, in particular from 95 ms to125 ms, in particular from 100 ms to 120 ms, in particular from 105 msto 115 ms, in particular from 105 ms to 110 ms.

Such a value of the second timing parameter value is appropriate forcovering most of His bundle pacing scenarios so that presetting thesecond timing parameter to a value falling in this range facilitates useof the programming device. If a user wants to accept the preset value,no other value needs to be chosen. However, it is still possible toamend the second timing parameter value to a value different from thepreset value so that presetting the second timing parameter value doesnot limit the configuration possibilities.

In an embodiment, the first computer-readable program causes the firstprocessor to prevent selecting the second timing parameter value if thefirst electrode lead configuration is selected. Likewise, the firstcomputer-readable program causes the first processor to preventselecting the first timing parameter value if the second electrode leadconfiguration is selected. Such prevention can be effected, e.g., bygreying out individual fields in a graphic user interface or bypresenting an input mask that is specifically adapted either forselecting the first timing parameter value or for selecting the secondtiming parameter value.

In an embodiment, the first computer-readable program causes the firstprocessor to allow both selecting the first timing parameter value andselecting the second timing parameter value if the second electrode leadconfiguration is selected. Such a possibility of choosing both timingparameters is particularly appropriate if the implantable medical deviceto be programmed does not only comprise a His bundle electrode lead, butalso a His bundle electrode backup lead. Such a His bundle electrodebackup lead is typically realized in form of a right ventricularelectrode lead that is implanted into the right ventricle of the heartto be stimulated, e.g., in an apical region of the right ventricle. If acardiac stimulation using the His bundle electrode is not possible, theHis bundle electrode backup lead can be used for a conventional rightventricular cardiac stimulation. Since the His bundle electrode backuplead is typically operated under the similar or the samestimulation/sensing parameters like a conventional right ventricularelectrode (i.e., different than a His bundle electrode), it is helpfulto set a physiologic appropriate first timing parameter for such Hisbundle electrode backup lead. Then, the second timing parameter valuewill be used in case of His bundle pacing, whereas the first timingparameter value is used in case that His bundle pacing has not beensuccessful and backup pacing by the His bundle electrode backup lead isnecessary.

In an embodiment, the at least two electrode lead configurations do notonly comprise the first electrode lead configuration and the secondelectrode lead configuration, but additionally a third electrode leadconfiguration. In this third electrode lead configuration, an atrialelectrode lead, a His bundle electrode lead, and a His bundle electrodebackup lead are connected to corresponding electrode lead ports of theimplantable medical device. It is possible that the option of allowingboth selecting the first timing parameter value and selecting the secondtiming parameter value is only available if the third electrode leadconfiguration is selected. Then, the first timing parameter value canonly be chosen in case that either a conventional right ventricularelectrode is connected to an electrode lead port of the implantablemedical device or in case that a His bundle electrode backup lead isprovided, but not in case that only a His bundle electrode lead is usedfor His bundle pacing without providing a His bundle electrode backuplead.

In an embodiment, the first computer-readable program causes the firstprocessor to transfer the selected first timing parameter value or theselected second timing parameter value to an appliance remote from theprogramming device. In doing so, the selected first timing parametervalue or the selected second timing parameter value can be convertedinto a data form that is conceivable by the appliance or a user of theappliance. However, it is also possible to transfer the selected firsttiming parameter value or the selected second timing parameter value tothe appliance without conversion. The appliance is chosen from the groupconsisting of a printout (or a printer for making a printout), adatabase, and a home monitoring system. A particular appropriatedatabase is a database comprising electronic health records (EHR). Togive an example, a clinic information system might be an appropriatedatabase. Upon transferring the selected first timing parameter value orthe selected second timing parameter value to such an appliance, theselected first timing parameter value or the selected second timingparameter value will be available in the appliance at a later timepoint. Then, it is particularly easy to identify the concrete settingsof the intended conventional cardiac pacing or the intended His bundlepacing, even though the programming device might not be at hand at thattime point.

In an aspect, the present invention relates to a computer programproduct comprising computer-readable code that causes a processor toperform the steps explained in the following when executed on theprocessor.

First, a selection between at least two electrode lead configurations ofan implantable medical device for stimulating a human or animal heart ismade possible. The at least two electrode lead configurations comprise afirst electrode lead configuration and a second electrode leadconfiguration. In the first electrode lead configuration, an atrialelectrode lead and a right ventricular electrode lead are connected tocorresponding electrode lead ports of the implantable medical device. Inthe second electrode lead configuration, an atrial electrode lead and aHis bundle electrode lead are connected to corresponding electrode leadports of the implantable medical device.

If the first electrode lead configuration was selected, the programmingdevice then allows to select a first timing parameter value from a firstset of timing parameter values. If, however, the second electrode leadconfiguration was previously selected, the programming device allows toselect a second timing parameter value from a second set of timingparameter values. In this context, the first timing parameter value is avalue of an atrioventricular interval. The second timing parameter valueis a value of an atrial-His interval.

In an aspect, the present invention relates to an arrangement of theprogramming device according to the preceding explanations and animplantable medical device for stimulating a human or animal heart. Inaddition to the components explained above, the programming device alsocomprises a first data communication unit. Furthermore, the implantablemedical device comprises a second processor, a second memory unit, asecond data communication unit, a stimulation unit, and a detectionunit. The stimulation unit is configured to stimulate a cardiac regionof a human or animal heart. The detection unit is configured to detectan electric signal at the same or a different cardiac region of the sameheart. The stimulation unit and the detection unit comprise an electrodelead. This electrode lead can be the same or a different for thestimulation unit and the detection unit. By such an arrangement, it ispossible to use the programming device for programming the implantablemedical device, e.g., to set specific stimulation/sensing parameters, inparticular first and/or second timing parameters.

In an embodiment, the implantable medical device is an implantable pulsegenerator (IPG), an implantable cardioverter-defibrillator (ICD), or adevice for cardiac resynchronization therapy (CRT).

In an embodiment, the first data communication unit and the second datacommunication unit serve for transferring data from the programmingdevice to the implantable medical device and/or in the oppositedirection, i.e., from the implantable medical device to the programmingdevice. Thus, the programming device cannot only be used to program theimplantable medical device, but also to read out specific settings ofthe implantable medical device.

In an embodiment, the data communication units serve for transferringdata in a wireless manner. All standard data transmission protocols orspecifications are appropriate for such a wireless data communication.Examples of standard data transmission protocols or specifications arethe Medical Device Radiocommunications Service (MICS), the Bluetooth LowEnergy (BLE) protocol and the Zigbee specification.

In an embodiment, the second memory unit comprises a secondcomputer-readable program that causes the second processor to performthe steps explained in the following when executed on the secondprocessor.

First, a dataset comprising a first timing parameter value and/or asecond timing parameter value is received with the second datacommunication unit. The first timing parameter value is a value of anatrioventricular interval and the second timing parameter value is avalue of an atrial-His interval.

Afterwards, an atrioventricular interval to be applied by thestimulation unit is set to the first timing parameter value of thereceived dataset if the implantable medical device comprises an atrialelectrode lead and a right ventricular electrode lead (i.e., if thefirst electrode lead configuration has been selected in the programmingdevice). Otherwise, an atrial-His interval to be applied by thestimulation unit is set to the second timing parameter value of thereceived dataset if the implantable medical device comprises an atrialelectrode lead and a His bundle electrode lead (i.e., if the secondelectrode lead configuration has been selected in the programmingdevice).

In an embodiment, the second memory unit comprises a secondcomputer-readable program that causes the second processor to performthe steps explained in the following when executed on the secondprocessor.

In a first step, a presence of a His bundle electrode lead isautomatically detected. Such a His bundle electrode lead is configuredto stimulate the His bundle and/or to detect an electric signal at theHis bundle. The His bundle electrode is intended to be implanted or isimplanted at or near to the His bundle.

Alternatively, a dataset is received from the second memory unit thatindicates such a presence of a His bundle electrode. Such a dataset canbe generated by the programming device and can be transferred to theimplantable medical device after having made a selection of anappropriate electrode lead configuration in the programming device. Itis then stored in the second memory unit.

In a further step, the second data communication unit is caused totransfer a dataset indicating the presence of the His bundle electrodelead to the first data communication unit. Thus, the implantable medicaldevice is able to actively inform the programming device on a presenceof the His bundle electrode lead so that the selection of the electrodelead configuration to be made on the programming device can beautomatically performed on the basis of such transferred dataset.

To be more precise, in an embodiment, the first computer-readableprogram causes the first processor to perform the steps explained in thefollowing. First, the dataset indicating the presence of the His bundleelectrode lead is received with the first data communication unit.Afterwards, the second electrode lead configuration is automaticallyselected in response to having received this dataset.

This embodiment is particularly appropriate if a selection of anappropriate electrode lead configuration has already been done at anearlier time point and has been stored in the implantable medicaldevice. If a data connection is established between the implantablemedical device and the programming device at a later stage, theprogramming device can automatically receive an information on apresence of a His bundle electrode lead and can thus automaticallyselect the second electrode configuration for subsequent programmingpurposes. In such a case, a selection of the correct electrode leadconfiguration is made particularly easy and reliable. This enhances theoverall operational safety of the respective implantable medical device.

In an aspect, the present invention relates to a method for programmingan implantable medical device for stimulating a human or animal heartwith the programming device according to the preceding explanations. Inaddition to the components explained above, the programming device alsocomprises a first data communication unit. Furthermore, the implantablemedical device comprises a second processor, a second memory unit, asecond data communication unit, a stimulation unit, and a detectionunit. The stimulation unit is configured to stimulate a cardiac regionof a human or animal heart. The detection unit is configured to detectan electric signal at the same or a different cardiac region of the sameheart. The stimulation unit and the detection unit comprise an electrodelead. This electrode lead can be the same or a different for thestimulation unit and the detection unit. This method comprises the stepsexplained in the following.

First, a selection between at least two electrode lead configurations ofan implantable medical device for stimulating a human or animal heart ismade possible. The at least two electrode lead configurations comprise afirst electrode lead configuration and a second electrode leadconfiguration. In the first electrode lead configuration, an atrialelectrode lead and a right ventricular electrode lead are connected tocorresponding electrode lead ports of the implantable medical device. Inthe second electrode lead configuration, an atrial electrode lead and aHis bundle electrode lead are connected to corresponding electrode leadports of the implantable medical device.

If the first electrode lead configuration was selected, the programmingdevice then allows to select a first timing parameter value from a firstset of timing parameter values. If, however, the second electrode leadconfiguration was previously selected, the programming device allows toselect a second timing parameter value from a second set of timingparameter values. In this context, the first timing parameter value is avalue of an atrioventricular interval. The second timing parameter valueis a value of an atrial-His interval.

In a further step, a dataset comprising the first timing parameter valueand/or the second timing parameter value is generated with theprogramming device.

Afterwards, the dataset is transmitted to the implantable medical devicewith the first data communication unit.

The implantable medical device receives this dataset with the seconddata communication unit.

Finally, an atrioventricular interval to be applied by the stimulationunit is set to the first timing parameter value of the received datasetif the implantable medical device comprises an atrial electrode lead anda right ventricular electrode lead (i.e., if the first electrode leadconfiguration has been selected). Otherwise, an atrial-His interval tobe applied by the stimulation unit is set to the second timing parametervalue of the received dataset if the implantable medical devicecomprises an atrial electrode lead and a His bundle electrode lead(i.e., if the second electrode lead configuration has been selected).

All embodiments of the described programming device can be combined inany desired way and can be transferred either individually or in anyarbitrary combination to the arrangement, to the computer programproduct, and to the method. Furthermore, all embodiments described withrespect to the arrangement can be combined in any desired way and can betransferred either individually or in any arbitrary combination to thedescribed programming device, to the described computer program product,and to the described method. Likewise, all embodiments described withrespect to the computer program product can be combined in any desiredway and can be transferred either individually or in any arbitrarycombination to the described programming device, to the describedarrangement, and to the described method. Finally, all embodimentsdescribed with respect to the method can be combined in any desired wayand can be transferred either individually or in any arbitrarycombination to the described programming device, to the arrangement, andto the computer program product.

Additional features, aspects, objects, advantages, and possibleapplications of the present disclosure will become apparent from a studyof the exemplary embodiments and examples described below, incombination with the Figures and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Further details of aspects of the present invention will be described inthe following making reference to exemplary embodiments and accompanyingFigures. In the Figures:

FIG. 1A shows a first arrangement of a pacemaker and a programmingdevice;

FIG. 1B shows a second arrangement of a pacemaker and a programmingdevice;

FIG. 2 shows an embodiment of a set of atrioventricular intervals; and

FIG. 3 shows an embodiment of a set of atrial-His intervals.

DETAILED DESCRIPTION

FIG. 1A shows a first arrangement of a pacemaker 1 serving asimplantable medical device and a programming device 2. The pacemaker 1comprises a first port 3 serving as electrode lead port into which aright atrial electrode lead 4 is inserted. The right atrial electrodelead 4 comprises an electrode pole 5 at its distal end which isimplanted into the cardiac tissue of the right atrium 6 of a human heart7.

The pacemaker 1 comprises a second port 8 serving as electrode lead portinto which a right ventricular electrode lead 9 is inserted. The rightventricular electrode lead 9 comprises an electrode pole 10 at itsdistal end which is implanted into the cardiac tissue of an apicalregion of the right ventricle 11 of the human heart 7.

The programming device 2 comprises a display 12 for enabling aninteraction with a user of the programming device 2. The programmingdevice 2 and the pacemaker 1 are operatively coupled to each other by awireless radio communication 13. This wireless radio communication 13 isestablished by a first data communication unit in the programming device2 and a second data communication unit in the pacemaker 1. Due to thiswireless radio communication 13, it is possible to program the pacemaker1 with the help of the programming device 2.

For carrying out such programming, the programming device 2 firstrequests a selection between two electrode lead configurations. Thefirst electrode lead configuration is a standard (or conventional)electrode lead configuration with a right atrial electrode lead 4 and aright ventricular electrode lead 9, as depicted in FIG. 1A. If thisfirst electrode lead configuration is selected, a value of anatrioventricular interval serving as first timing parameter value can beafterwards selected from a set of atrioventricular interval values (cf.FIG. 2 ).

The second electrode lead configuration is an electrode leadconfiguration in which a right atrial electrode lead and a His bundleelectrode lead are present. Such an electrode lead configuration isshown in FIG. 1B. In this context, similar elements are denoted in thisand all following Figures with the same numeral references.

The general setting of the pacemaker 1 and the programming device 2 isidentical to the setting of FIG. 1A. Therefore, reference is made to theexplanations given above with respect to FIG. 1A. The only difference isthat in the embodiment of FIG. 1B no right ventricular electrode ispresent. Rather, a His bundle electrode 14 is connected to the secondport 8. The His bundle electrode lead 14 comprises an electrode pole 15at its distal end which is implanted into the His bundle 16 of the humanheart 7.

In case of the embodiment shown in FIG. 1B, the second electrode leadconfiguration is selected. This automatically results in the possibilityof selecting an atrial-His interval value from a set of atrial-Hisinterval values (cf. FIG. 3 ). The atrial-His interval value serves assecond timing parameter value.

FIG. 2 shows an embodiment of a set of atrioventricular intervals thatserves as first set of timing parameter values. This set ofatrioventricular intervals will be presented on the display 12 by thesoftware of the programming device 2 (cf. FIG. 1A) after the firstelectrode lead configuration has been selected. The set ofatrioventricular intervals comprises distinct atrioventricular intervalvalues lying in a range of from 40 ms to 350 ms. A user can select anindividual atrioventricular interval by clicking on the respective timewhen operating the programming device. It is also possible to confirmthe selection by pressing a distinct confirmation button. Anatrioventricular interval 16 (serving as first timing parameter value)of 180 ms is highlighted. This atrioventricular interval is preselectedso that the user can easily accept this value by clicking on it or byclicking on a separate confirmation button. However, the user is free toselect any other atrioventricular interval value of the set ofatrioventricular intervals.

FIG. 3 shows a set of atrial-His intervals serving as second set oftiming parameter values. This set of atrial-His interval will bepresented on the display 12 by the software of the programming device 2(cf. FIG. 1B) after the second electrode lead configuration has beenselected. The set of atrial-His intervals comprises distinct time valuesin a range of from 50 ms to 300 ms. An atrial-His interval 18 (servingas second timing parameter value) of 110 ms is highlighted so as toindicate that this atrial-His interval is preselected by the software ofthe programming device 2. This facilitates a choice of an appropriateatrial-His interval to be made by the user. The user of the programmingdevice can simply click on the field indicating 110 ms so as to selectthe atrial-His interval 18 of 110 ms. However, the user is free toselect any other atrial-His interval value of the set of atrial-Hisintervals if such other value better suits the concrete needs of thepacemaker 1 to be programmed by the programming device 2.

It will be apparent to those skilled in the art that numerousmodifications and variations of the described examples and embodimentsare possible in light of the above teachings of the disclosure. Thedisclosed examples and embodiments are presented for purposes ofillustration only. Other alternate embodiments may include some or allof the features disclosed herein. Therefore, it is the intent to coverall such modifications and alternate embodiments as may come within thetrue scope of this invention, which is to be given the full breadththereof. Additionally, the disclosure of a range of values is adisclosure of every numerical value within that range, including the endpoints.

1. Programming device for programming an implantable medical device forstimulating a human or animal heart, comprising a first processor and afirst memory unit, wherein the first memory unit comprises a firstcomputer-readable program that causes the first processor to perform thefollowing steps when executed on the first processor: a) allowing toselect one of at least two electrode lead configurations of animplantable medical device for stimulating a human or animal heart,wherein the at least two electrode lead configurations comprise: i) afirst electrode lead configuration in which an atrial electrode lead anda right ventricular electrode lead are connected to electrode lead portsof the implantable medical device, and ii) a second electrode leadconfiguration in which an atrial electrode lead and a His bundleelectrode lead are connected to electrode lead ports of the implantablemedical device; and b) allowing to select a first timing parameter valuefrom a first set of timing parameter values if the first electrode leadconfiguration is selected and to select a second timing parameter valuefrom a second set of timing parameter values if the second electrodelead configuration is selected, wherein the first timing parameter valueis a value of an atrioventricular interval and the second timingparameter value is a value of an atrial-His interval.
 2. Programmingdevice according to claim 1, wherein the first set of timing parametervalues comprises values lying in a time range of from 40 ms to 350 ms.3. Programming device according to claim 1, wherein the first timingparameter value is preset to a time lying in a range of from 150 ms to210 ms.
 4. Programming device according to claim 1, wherein the secondset of timing parameter values comprises values lying in a time range offrom 15 ms to 300 ms.
 5. Programming device according to claim 1,wherein the second timing parameter value is preset to a time lying in arange of from 80 ms to 140 ms.
 6. Programming device according to claim1, wherein the first computer-readable program causes the firstprocessor to prevent selecting the second timing parameter value if thefirst electrode lead configuration is selected and to prevent selectingthe first timing parameter value if the second electrode leadconfiguration is selected.
 7. Programming device according to claim 1,wherein the first computer-readable program causes the first processorto allow both selecting the first timing parameter value and selectingthe second timing parameter value if the second electrode leadconfiguration is selected.
 8. Programming device according to claim 1,wherein the first computer-readable program causes the first processorto transfer the selected first timing parameter value or the selectedsecond timing parameter value to an appliance remote from theprogramming device, the appliance being chosen from the group consistingof a printout, a database, and a home monitoring system.
 9. Computerprogram product comprising computer-readable code that causes aprocessor to perform the following steps when executed on the processor:a) allowing to select one of at least two electrode lead configurationsof an implantable medical device for stimulating a human or animalheart, wherein the at least two electrode lead configurations comprise:i) a first electrode lead configuration in which an atrial electrodelead and a right ventricular electrode lead are connected to electrodelead ports of the implantable medical device, and ii) a second electrodelead configuration in which an atrial electrode lead and a His bundleelectrode lead are connected to electrode lead ports of the implantablemedical device; and b) allowing to select a first timing parameter valuefrom a first set of timing parameter values if the first electrode leadconfiguration is selected and to select a second timing parameter valuefrom a second set of timing parameter values if the second electrodelead configuration is selected, wherein the first timing parameter valueis a value of an atrioventricular interval and the second timingparameter value is a value of an atrial-His interval.
 10. Arrangementcomprising a programming device according to claim 1 and an implantablemedical device for stimulating a human or animal heart, wherein theprogramming device comprises a first data communication unit and whereinthe implantable medical device comprises a second processor, a secondmemory unit, a second data communication unit, a stimulation unitconfigured to stimulate a cardiac region of a human or animal heart, anda detection unit configured to detect an electric signal at the cardiacregion of the same heart.
 11. Arrangement according to claim 10, whereinthe first data communication unit and the second data communication unitserve for transferring data from the programming device to theimplantable medical device and/or for transferring data from theimplantable medical device to the programming device.
 12. Arrangementaccording to claim 10, wherein the second memory unit comprises a secondcomputer-readable program that causes the second processor to performthe following steps when executed on the second processor: a) receiving,with the second data communication unit, a dataset comprising a firsttiming parameter value and/or a second timing parameter value, whereinthe first timing parameter value is a value of an atrioventricularinterval and the second timing parameter value is a value of anatrial-His interval; and b) setting an atrioventricular interval to beapplied by the stimulation unit to the first timing parameter value ofthe received dataset if the implantable medical device comprises anatrial electrode lead and a right ventricular electrode lead and/orsetting an atrial-His interval to be applied by the stimulation unit tothe second timing parameter value of the received dataset if theimplantable medical device comprises an atrial electrode lead and a Hisbundle electrode lead.
 13. Arrangement according to claim 10, whereinthe second memory unit comprises a second computer-readable program thatcauses the second processor to perform the following steps when executedon the second processor: a) automatically detecting a presence of a Hisbundle electrode lead connected to an electrode lead port of theimplantable medical device; and b) causing the second data communicationunit to transfer a dataset indicating the presence of the His bundleelectrode lead to the first data communication unit.
 14. Arrangementaccording to claim 13, wherein the first computer-readable programcauses the first processor to perform the following steps: a) receiving,with the first data communication unit, the dataset indicating thepresence of the His bundle electrode lead; and b) automaticallyselecting the second electrode lead configuration in response toreceiving this dataset.
 15. Method for programming an implantablemedical device for stimulating a human or animal heart with aprogramming device according to claim 1, wherein the programming devicecomprises a first data communication unit and wherein the implantablemedical device comprises a second processor, a second memory unit, asecond data communication unit, a stimulation unit configured tostimulate a cardiac region of a human or animal heart, and a detectionunit configured to detect an electric signal at the cardiac region ofthe same heart, the method comprising the following steps: a) allowingto select one of at least two electrode lead configurations of theimplantable medical device, wherein the at least two electrode leadconfigurations comprise: i) a first electrode lead configuration inwhich an atrial electrode lead and a right ventricular electrode leadare connected to electrode lead ports of the implantable medical device,and ii) a second electrode lead configuration in which an atrialelectrode lead and a His bundle electrode lead are connected toelectrode lead ports of the implantable medical device; b) allowing toselect a first timing parameter value from a first set of timingparameter values if the first electrode lead configuration is selectedand to select a second timing parameter value from a second set oftiming parameter values if the second electrode lead configuration isselected, wherein the first timing parameter value is a value of anatrioventricular interval and the second timing parameter value is avalue of an atrial-His interval; c) generating, with the programmingdevice, a dataset comprising the first timing parameter value and/or thesecond timing parameter value; d) transmitting, with the first datacommunication unit, the dataset to the implantable medical device; e)receiving, with the second data communication unit, the dataset; and f)setting an atrioventricular interval to be applied by the stimulationunit to the first timing parameter value of the received dataset if thefirst electrode lead configuration has been selected or setting anatrial-His interval to be applied by the stimulation unit to the secondtiming parameter value of the received dataset if the second electrodelead configuration has been selected.